2018, Number 5
<< Back Next >>
Med Int Mex 2018; 34 (5)
Fever of unknown origin as manifestation of systemic lupus erythematosus
Fuentes-Márquez L, Izquierdo-Pérez M, Maestre-Serrano R, Barrera-Guarin C
Language: Spanish
References: 19
Page: 792-796
PDF size: 354.80 Kb.
ABSTRACT
Fever of unknown origin is defined as a clinical spectrum of patients who consulted for
presenting fever as a single or predominant manifestation, greater or equal to 38.3ºC,
more than 3 weeks of evolution, and in whom clinical evaluation results and initial
paraclinical studies have not identified its cause. Five categories group the causes
of fever of unknown origin which include infectious, neoplastic, inflammatory noninfectious,
miscellaneous and of unknown origin. Systemic lupus erythematosus is an
autoimmune disease that affects connective tissue and has a wide range of clinical
manifestations, among which the presence of polyarthritis, mucocutaneous ulcers and
malar erythema stand out at the beginning; systemic lupus erythematosus is one of the
non-infectious inflammatory causes of fever of unknown origin. A clinical case report
is made, of a 51-year-old woman, who consulted to Internal Medicine, with a clinical
picture of 30 days of evolution, with intermittent fever, daily and quantified between
38.5 and 39ºC, associated with significant weight loss; to which it was diagnosed by
clinical and paraclinical findings systemic lupus erythematosus, treated with hydroxychloroquine
and prednisolone, achieving disappearance of the fever and improvement
of the general state of the patient.
REFERENCES
Tolia J, et al. Fever of unknown origin: Historical and physical clues to making the diagnosis. Infect Dis Clin N Am 2007;21(4):917-36.
Bennett JE, et as, and Bennett’s principles and practice of infectious diseases. 8th ed. Philadelphia: Elsevier Saunders, 2015.
Zenone T. Fever of unknown origin in rheumatic diseases. Infect Dis Clin N Am 2007;21(4):1115-35.
Casarrubias-Ramírez M y col. Fiebre de origen oscuro, comparación de dos series con 26 años de diferencia. Revista Médica del Instituto Mexicano del Seguro Social 2015;53(1):S7-S17.
Guerrero Sánchez F y col. Fiebre de origen incierto. Medicine 2002;8(72):3881-3886.
Cunha BA, et al. Fever of unknown origin: a clinical approach. Am J Med 2015;128(10):1138.e1-1138.e15
Kasper D, et al. Principios de Medicina Interna, 19ª ed. McGraw-Hill Interamericana Editores, 2016.
Beyan E, et al. An uncommon cause of fever in the elderly: late-onset systemic lupus erythematosus. Clin Rheumatol 2003;22(6):481-483.
Aguirre HD y col. Lupus eritematoso sistémico en el anciano: una presentación atípica de una enfermedad común. Rev Colomb Reumatol 2014;21(2):104-108.
Ernst D y col. Fiebre de origen desconocido como forma de presentación atípica de mieloma múltiple: Caso clínico. Rev Méd Chile 2009;137:1051-53.
Petelin A, et al. Fever of unknown origin (FUO) due to systemic lupus erythematosus (SLE) presenting as pericarditis. Heart Lung 2013;42(2)152-3.
Cunha BA. Fever of unknown origin: clinical overview of classic and current concepts. Infect Dis Clin N Am 2007;21(4):867-915.
Mulders-Manders CM, et al. Rheumatologic diseases as the cause of fever of unknown origin Best Pract Res Clin Rheumatol 2016;30(5):789-801.
Bleeker-Rovers CP, et al. A prospective multicenter study on fever of unknown origin: the yield of a structured diagnostic protocol. Medicine (Baltimore) 2007;86(1):26-38.
Popovska-Jovicić B, et al. Fever of unknown origin: Most frequent causes in adults patients. Vojnosanit Pregl 2016;73(1):21-5.
Yamanouchi M, et al. Analysis of 256 cases of classic fever of unknown origin. Intern Med 2014;53(21):2471-5.
Salehi-Abar I. 2015 ACR/SLICC Revised criteria for diagnosis of systemic lupus erythematosus. Autoimmune Dis Ther Approaches 2015;2(1):1-4.
Mete B, et al. The role of invasive and non-invasive procedures in diagnosing fever of unknown origin. Int J Med Sci 2012;9(8):682-89.
Kucukardali Y, et al. The spectrum of diseases causing fever of unknown origin in Turkey: a multicenter study. Int J Infect Dis 2008;12(1):71-79.